| A | B |
|---|
| Abdominal distension - common causes | fat, flatus, fluid, fetus, feces, fibroids |
| Obesity - assessment findings | uniformly rounded, sunken umbilicus |
| Gaseous distension - assessment findings | generalized tympany on percussion |
| Ascites - assessment findings | everted umbilicus + fluid wave and shifting dullness on percussion |
| Feces - assessment findings | palpable rope-like or sausage-shaped mass in lower or mid abdomen |
| Umbilical - eversion vs deeply sunken with abdominal distension | dependent on whether cause of abdominal distension occurs below or above peritoneum (umbilicus adheres to peritoneum - adipose tissue lies between skin and peritoneum) |
| Hepatitis (inflammation of liver) - common symptoms | dull pain RUQ or epigastrium accompanied by anorexia, nausea, malaise |
| Gastroesophageal reflux disease (GERD) - common symptoms | burning pain midepigastrium or behind lower sternum radiating upward - occurs 30 min. to 1 hr pc and is aggravated by lying down or bending over |
| Cholecytitis (inflammation of gall bladder) - common symptoms | colicky RUQ pain that may radiate to scapula(e) - increased with intake of fatty foods, alcohol, caffeine - often with nausea and vomiting |
| Cholecystitis (inflammation of gall bladder) - assessment findings | positive Murphy's sign (respiratory arrest mid-inspiration during RUQ palpation) |
| Pancreatitis - common symptoms | acute, boring mideigastric pain radiating to the back and sometimes to left scapula and flank - often with severe nausea and vomiting |
| Duodenal ulcer - common symptoms | dull, aching, gnawing pain relieved by food intake (empty stomach may awaken from sleep) |
| Gastric ulcer - common symptoms | dull, aching, gnawing epigastric pain that may radiate to back and substernal area - usually aggravated by intake |
| Perforated ulcer - common symptoms | radiation of pain to one or both shoulders due to diaphragmatic irritation |
| Appendicitis - common symptoms | initially dull and diffuse periumbilical pain that progresses to severe, sharp, RLQ pain that is worsened by movement - usually with N/V |
| Appendicitis - assessment findings | rebound tenderness, positive iliopsoas test |
| Nephrolithiasis (kidney stones) - common symptoms | sudden severe colicky pain - usually in flank - may radiate to lower abdomen, groin, genitalia |
| Gastroenteritis (stomach and intestinal inflammation (often due to bacterial infection) - common symptoms | diffuse, generalized abdominal pain with nausea and diarrhea |
| Irritable bowel syndrome - common symptoms | lower abdominal pain, bloating, cramping relieved by bowel movement |
| Rectal lesions - common symptoms | lumbar pain, reports of blood passed with bowel movement |
| Splenomegaly - assessment findings | increased area of dullness and palpable (normally is well within ribcage and must be enlarged 3x normal to be palpated) |
| Pregnancy - common abdominal and GI changes | pyrosis (heartburn), decreased GI motility, constipation, hemorrhoids, striae |
| Aging - common abdominal and GI changes | decreased salivation, delayed esophageal emptying (increases aspiration risk), decreased gastric acid secretion (may lead to pernicious anemia and malabsorption), decreased liver size, constipation (often due to extraneous causes) |
| Lactose intolerance (due to lactase deficiency) - common symptoms | abdominal pain, bloating, and flatulence after intake of milk products - incidence up to 70-90% in persons of African, Native American, Asian, and Mediterranean descent |
| Aortic aneurysm - assessment findings | marked pulsation, palpable pulsating mass, bruit, decreased femoral pulses |
| Peritonitis(inflammation of peritoneum) - assessment findings | patient restricts movement, involuntary rigidity, hypoactive bowel sounds, rebound tenderness, positive iliopsoas muscle test and obturator test |
| Diastasis recti - assessment findings | longitudinal ridge on increased intraabdominal pressure, may palpate separation when supine |
| Umbilical hernia - assessment findings | bulging at umbilicus - common in black infants but usually disappears by childhood |
| Pyloric Stenosis - assessment findings | succussion splash, olive-sized mass in RUQ |
| Epigastric hernia - assessment findings | bulding in epigastrium at midline |
| Incisional hernia - assessment findings | bulging at an operative scar site, especially with increased intraabdominal pressure |
| Renal stenosis - assessment findings | bruit or murmur at midline toward flank |
